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Emergency Care



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Pub. Date:
Prentice Hall
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Emergency Care, 10/Ehas prepared more students to pass state and/or the National Registry Exam than any other text on the market with well-organized, clearly presented content, thorough coverage of patient assessment, an accessible reading level, high quality artwork, and outstanding skill scans of equipment and procedures. Case studies and practical tips from the field tie chapter concepts to real world applications. Each chapter sends students to the Companion Website where there are links to EMS-related sites. A new in-text CD provides extra information to help students master concepts. Emergency Care AHA Update reflects the American Heart Association's 2005 CPR and ECC guidelines.

Table of Contents

Introduction to Emergency Medical Carep. 4
The Emergency Medical Services Systemp. 6
How It Beganp. 6
EMS Todayp. 7
Components of the EMS Systemp. 8
Accessing the EMS Systemp. 9
Levels of EMS Trainingp. 10
Roles and Responsibilities of the EMT-Bp. 10
Traits of a Good EMT-Bp. 11
Where Will You Become a Provider?p. 13
National Registry of Emergency Medical Techniciansp. 14
Quality Improvementp. 14
Medical Directionp. 15
Special Issuesp. 16
Chapter Reviewp. 17
Street Scenesp. 18
The Well-Being of the EMT-Basicp. 20
Personal Protectionp. 22
Body Substance Isolation (BSI) Precautionsp. 22
Personal Protective Equipmentp. 23
FYI: Diseases of Concernp. 25
Immunizationsp. 30
Emotion and Stressp. 30
Physiologic Aspects of Stressp. 30
Types of Stress Reactionsp. 31
Causes of Stressp. 33
Signs and Symptoms of Stressp. 33
Dealing with Stressp. 33
Scene Safetyp. 35
Hazardous Materials Incidentsp. 35
Rescue Operationsp. 37
Violencep. 37
Chapter Reviewp. 41
Street Scenesp. 42
Medical/Legal and Ethical Issuesp. 43
Scope of Practicep. 45
Patient Consent and Refusalp. 45
Consentp. 45
When a Patient Refuses Carep. 46
Do Not Resuscitate Ordersp. 49
Other Legal Aspectsp. 50
Negligencep. 50
Duty to Actp. 51
Good Samaritan Lawsp. 51
Confidentialityp. 51
Special Situationsp. 52
Crime Scenesp. 53
Special Crimes and Reportingp. 55
Chapter Reviewp. 56
Street Scenesp. 57
The Human Bodyp. 59
Anatomical Termsp. 61
Directional Termsp. 61
Positional Termsp. 63
Body Systemsp. 65
Musculoskeletal Systemp. 65
Respiratory Systemp. 69
Cardiovascular Systemp. 71
Nervous Systemp. 76
Digestive Systemp. 78
Skinp. 79
Endocrine Systemp. 80
FYI: Locating Body Organs and Structuresp. 81
Chapter Reviewp. 93
Street Scenesp. 97
Lifting and Moving Patientsp. 99
Protecting Yourself: Body Mechanicsp. 101
Protecting Your Patient: Emergency, Urgent, and Non-Urgent Movesp. 103
Emergency Movesp. 103
Urgent Movesp. 106
Non-Urgent Movesp. 107
Chapter Reviewp. 121
Street Scenesp. 122
Airway Managementp. 126
Respirationp. 128
Adequate and Inadequate Breathingp. 129
Opening the Airwayp. 133
Head-Tilt, Chin-Lift Maneuverp. 135
Jaw-Thrust Maneuverp. 136
Techniques of Artificial Ventilationp. 137
Mouth-to-Mask Ventilationp. 138
Bag-Valve Maskp. 140
Flow-Restricted, Oxygen-Powered Ventilation Devicep. 144
Airway Adjunctsp. 144
Rules for Using Airway Adjunctsp. 146
Oropharyngeal Airwaysp. 146
Nasopharyngeal Airwaysp. 147
Suctioningp. 151
Suctioning Devicesp. 151
Techniques of Suctioningp. 153
Oxygen Therapyp. 155
Importance of Supplemental Oxygenp. 155
Oxygen Therapy Equipmentp. 156
Hazards of Oxygen Therapyp. 160
Administering Oxygenp. 161
Special Considerationsp. 168
Chapter Reviewp. 170
Street Scenesp. 172
Patient Assessment
Scene Size-upp. 176
Scene Size-upp. 178
Scene Safetyp. 178
Nature of the Callp. 184
Number of Patients and Adequacy of Resourcesp. 191
Chapter Reviewp. 192
Street Scenesp. 193
The Initial Assessmentp. 194
The Initial Assessmentp. 196
Form a General Impressionp. 196
Cultural Considerationsp. 197
Assess Mental Statusp. 200
Assess the ABCsp. 200
Determine Priorityp. 201
Patient Characteristics and Initial Assessmentp. 203
Comparing the Initial Assessmentsp. 206
Chapter Reviewp. 208
Street Scenesp. 209
Vital Signs and Sample Historyp. 210
Gathering the Vital Signs and Historyp. 212
Vital Signsp. 212
Pulsep. 213
Respirationp. 215
Skinp. 216
Pupilsp. 218
Blood Pressurep. 218
Oxygen Saturationp. 222
Sample Historyp. 224
Cultural Considerationsp. 224
Chapter Reviewp. 226
Street Scenesp. 229
Assessment of the Trauma Patientp. 230
Focused History and Physical Exam for the Trauma Patientp. 232
Trauma Patient with No Significant Mechanism of Injuryp. 233
Applying a Cervical Collarp. 236
Trauma Patient with a Significant Mechanism of Injuryp. 237
Cultural Considerationsp. 247
Some General Principlesp. 253
Detailed Physical Examp. 254
Trauma Patient with a Significant Mechanism of Injuryp. 254
Trauma Patient with No Significant Mechanism of Injuryp. 261
Comparing Assessmentsp. 261
Chapter Reviewp. 266
Street Scenesp. 268
Assessment of the Medical Patientp. 269
Focused History and Physical Exam for a Medical Patientp. 271
Responsive Medical Patientp. 271
Unresponsive Medical Patientp. 277
Comparing Assessmentsp. 280
Chapter Reviewp. 284
Street Scenesp. 285
Ongoing Assessmentp. 2868
Ongoing Assessmentp. 288
Components of the Ongoing Assessmentp. 289
Observing Trendsp. 290
Ongoing Assessment for Stable and Unstable Patientsp. 291
Comparing Assessmentsp. 291
Chapter Reviewp. 294
Street Scenesp. 294
Communicationsp. 296
Communications Systems and Radio Communicationp. 298
Communications Systemsp. 298
Radio Communicationp. 299
The Verbal Reportp. 303
Interpersonal Communicationp. 303
Chapter Reviewp. 306
Street Scenesp. 307
Documentationp. 308
Prehospital Care Reportp. 310
Functions of the Prehospital Care Reportp. 310
Elements of the Prehospital Care Reportp. 314
Cultural Considerationsp. 317
Special Documentation Issuesp. 318
Legal Issuesp. 318
Special Situationsp. 322
Chapter Reviewp. 326
Street Scenesp. 327
Medical Emergencies
General Pharmacologyp. 330
Medications EMT-Basics Can Administerp. 332
Medications on the Ambulancep. 332
Prescribed Medicationsp. 333
General Information About Medicationsp. 335
Drug Namesp. 335
What You Need to Know When Giving a Medicationp. 336
FYI: Medications Patients Often Takep. 337
Chapter Reviewp. 339
Street Scenesp. 340
Respiratory Emergenciesp. 342
Respirationp. 344
Respiratory Anatomy and Physiologyp. 344
Adequate Breathingp. 345
Inadequate Breathingp. 345
Adequate and Inadequate Artificial Ventilationp. 348
Breathing Difficultyp. 349
FYI: Respiratory Assessment and Conditionsp. 351
The Prescribed Inhalerp. 354
FYI: Small-Volume Nebulizerp. 356
Chapter Reviewp. 360
Street Scenesp. 361
Cultural Considerationsp. 363
Cardiac Emergenciesp. 364
Cardiac Anatomy and Physiologyp. 367
Cardiac Compromisep. 367
Cultural Considerationsp. 369
Management of Cardiac Compromisep. 369
FYI: Causes of Cardiac Compromisep. 375
Cardiac Arrestp. 378
Chain of Survivalp. 378
FYI: Controlled Hypothermiap. 381
Management of Cardiac Arrestp. 381
Automated External Defibrillator (AED)p. 381
Special Considerations for AED Usep. 391
FYI: Implants and Surgeriesp. 395
Chapter Reviewp. 401
Street Scenesp. 402
Acute Abdominal Emergenciesp. 405
Abdominal Anatomy and Physiologyp. 406
Abdominal Pain and Distressp. 408
Assessment and Care of Abdominal Distressp. 408
Cultural Considerationsp. 411
General Abdominal Distressp. 415
FYI: Abdominal Conditionsp. 415
Chapter Reviewp. 417
Street Scenesp. 418
Diabetic Emergencies and Altered Mental Statusp. 420
Diabetesp. 422
Diabetic Emergenciesp. 422
Blood Glucose Metersp. 425
Cultural Considerationsp. 426
FYI: Additional Information on Diabetesp. 429
Other Causes of Altered Mental Statusp. 430
Seizure Disordersp. 430
FYI: Types of Seizuresp. 432
Strokep. 433
Dizziness and Syncopep. 436
Chapter Reviewp. 440
Street Scenesp. 441
Allergic Reactionsp. 443
Allergic Reactionsp. 445
Distinguishing Anaphylaxis from Mild Allergic Reactionp. 447
Self-Administered Epinephrinep. 451
Chapter Reviewp. 454
Street Scenesp. 455
Poisoning and Overdose Emergenciesp. 457
Poisoningp. 459
Ingested Poisonsp. 460
FYI: Food Poisoningp. 461
FYI: Antidotesp. 464
Inhaled Poisonsp. 465
FYI: Smoke Inhalationp. 468
Absorbed Poisonsp. 468
Injected Poisonsp. 469
Alcohol and Substance Abusep. 469
Alcohol Abusep. 469
FYI: Poison Control Centersp. 471
Substance Abusep. 473
Chapter Reviewp. 478
Street Scenesp. 479
Environmental Emergenciesp. 481
Exposure to Coldp. 483
How the Body Loses Heatp. 483
Generalized Hypothermiap. 484
Localized Cold Injuriesp. 488
Exposure to Heatp. 490
Effects of Heat on the Bodyp. 490
Patient with Moist, Pale, Normal-to-Cool Skinp. 491
Patient with Hot, Dry or Moist Skinp. 492
Water-Related Emergenciesp. 493
Water-Related Accidentsp. 493
Drowning and Near-Drowningp. 494
Diving Accidentsp. 498
FYI: Scuba Diving Accidentsp. 498
FYI: Water Rescues; Ice Rescuesp. 500
Bites and Stingsp. 500
Insect Bites and Stingsp. 500
Snakebitesp. 503
Poisoning from Marine Lifep. 505
Chapter Reviewp. 507
Street Scenesp. 508
Behavioral Emergenciesp. 510
Behavioral Emergenciesp. 512
What Is a Behavioral Emergency?p. 512
Physical Causes of Altered Behaviorp. 512
Situational Stress Reactionsp. 513
Emergency Care for Behavioral Emergenciesp. 514
Psychiatric Emergenciesp. 514
Suicidep. 515
Aggressive or Hostile Patientsp. 517
Reasonable Force and Restraintp. 517
Transport to an Appropriate Facilityp. 518
Medical/Legal Considerationsp. 520
Chapter Reviewp. 521
Street Scenesp. 522
Obstetrics and Gynecological Emergenciesp. 524
Anatomy and Physiology of Childbirthp. 526
Pregnancy and Deliveryp. 526
Laborp. 527
Labor Painsp. 528
Normal Childbirthp. 529
Role of the EMT-Basicp. 529
Normal Deliveryp. 530
Cultural Considerationsp. 535
The Newbornp. 535
Assessing the Newbornp. 535
Caring for the Motherp. 538
Childbirth Complicationsp. 540
Complications of Deliveryp. 540
Emergencies in Pregnancyp. 545
FYI: Childbirth and Death; Stillbirths; Accidental Death of a Pregnant Womanp. 549
Gynecological Emergenciesp. 549
Chapter Reviewp. 551
Street Scenesp. 553
Putting It All Together for the Medical Patientp. 555
Multiple Medical Complaintsp. 556
Managing the Patient with Multiple Medical Complaintsp. 556
Typical Callsp. 556
Cultural Consisderationsp. 557
Analysis of the Callsp. 560
Patient Conditions Not Covered in the EMT-B Coursep. 560
Chapter Reviewp. 562
Street Scenesp. 562
Bleeding and Shockp. 566
Circulatory Systemp. 568
Main Componentsp. 568
FYI: Functions of the Bloodp. 569
Bleedingp. 569
External Bleedingp. 569
Internal Bleedingp. 578
Shock (Hypoperfusion)p. 580
Causes of Shockp. 580
FYI: Types of Shockp. 581
Severity of Shockp. 581
Cultural Considerationsp. 582
Emergency Carep. 583
Chapter Reviewp. 588
Street Scenesp. 589
Soft-Tissue Injuriesp. 591
Soft Tissuesp. 593
Closed Woundsp. 594
Types of Closed Woundsp. 594
Open Woundsp. 596
Types of Open Woundsp. 596
Emergency Care for Open Woundsp. 600
Treating Specific Types of Open Woundsp. 601
Treating Abrasions and Lacerationsp. 601
Treating Puncture Woundsp. 601
Treating Impaled Objectsp. 602
Treating Avulsionsp. 605
Treating Amputationsp. 605
Wounds to the Neckp. 605
Chest Injuriesp. 606
FYI: Chest Injury Complicationsp. 610
Abdominal Injuriesp. 611
Burnsp. 613
Classifying Burns by Agent and Sourcep. 613
Classifying Burns by Depthp. 615
Determining the Severity of Burnsp. 616
Classifying Burns by Severityp. 618
Treating Specific Types of Burns and Electrical Injuriesp. 619
Electrical Injuriesp. 622
FYI: Specific Chemical Burnsp. 623
Dressing and Bandagingp. 625
Chapter Reviewp. 629
Street Scenesp. 631
Musculoskeletal Injuriesp. 633
Musculoskeletal Systemp. 635
Anatomy of Bonep. 636
Self-Healing Nature of Bonep. 638
Muscles, Cartilage, Ligaments, and Tendonsp. 639
General Guidelines for Emergency Carep. 640
Mechanisms of Musculoskeletal Injuryp. 640
Painful, Swollen, or Deformed Extremityp. 640
Assessment of Musculoskeletal Injuriesp. 643
Splintingp. 644
Emergency Care of Specific Injuriesp. 652
Upper Extremity Injuriesp. 653
Lower Extremity Injuriesp. 653
Chapter Reviewp. 679
Street Scenesp. 680
Injuries to the Head and Spinep. 682
Nervous and Skeletal Systemsp. 684
Nervous Systemp. 684
Anatomy of the Headp. 685
Anatomy of the Spinep. 686
Injuries to the Skull and Brainp. 686
Scalp Injuriesp. 686
Skull Injuriesp. 686
Brain Injuriesp. 687
FYI: Types of Brain Injuriesp. 688
FYI: Glasgow Coma Scalep. 690
Cranial Injuries with Impaled Objectsp. 692
Injuries to the Face and Jawp. 692
Nontraumatic Brain Injuriesp. 693
Injuries to the Spinep. 693
Mechanisms of Injuryp. 693
Immobilization Issuesp. 698
Tips for Applying a Cervical Collarp. 698
Tips for Immobilizing a Seated Patientp. 698
Tips for Applying a Long Backboardp. 703
Tips for Dealing with a Standing Patientp. 708
Patient Found Wearing a Helmetp. 712
FYI: Selective Spine Immobilizationp. 718
Chapter Reviewp. 720
Street Scenesp. 721
Putting It All Together for the Trauma Patientp. 723
Multiple Traumap. 724
Cultural Considerationsp. 724
Managing the Multiple-Trauma Patientp. 725
A Typical Callp. 725
Analysis of the Callp. 727
General Principles of Multiple-Trauma Managementp. 728
FYI: Trauma Scoringp. 729
Chapter Reviewp. 731
Street Scenesp. 731
Younger and Older Patients
Infants and Childrenp. 736
Developmental Characteristics of Infants and Childrenp. 738
Psychological and Personality Characteristicsp. 741
Anatomical and Physiological Differencesp. 741
Interacting with the Pediatric Patientp. 743
The Adolescent Patientp. 744
Supporting the Parents or Other Care Providersp. 745
Assessing the Pediatric Patientp. 746
Pediatric Assessment Triangle (PAT)p. 746
Scene Size-up and Safety-Pediatricp. 747
Initial Assessment-Pediatricp. 747
Focused History and Physical Exam-Pediatricp. 749
Detailed Physical Exam-Pediatricp. 750
Ongoing Assessment-Pediatricp. 755
Comparing Assessmentsp. 755
Special Concerns in Pediatric Carep. 757
Maintaining an Open Airwayp. 757
Clearing an Airway Obstructionp. 759
Infant and Child BCLS Reviewp. 762
Providing Supplemental Oxygen and Ventilationsp. 762
Caring for Shock (Hypoperfusion)p. 764
Protecting Against Hypothermiap. 765
Medical Emergenciesp. 766
Respiratory Disordersp. 766
Respiratory Distressp. 766
FYI: Respiratory Diseasesp. 767
FYI: Meningitisp. 769
Feverp. 770
Diarrhea and Vomitingp. 771
Seizuresp. 771
Altered Mental Statusp. 772
Poisoningp. 773
Near-Drowningp. 773
Sudden Infant Death Syndromep. 774
Traumap. 775
Injury Patternsp. 775
Pneumatic Anti-Shock Garmentsp. 777
Burnsp. 777
Child Abuse and Neglectp. 778
Physical and Sexual Abusep. 778
Role of the EMT-B in Cases of Suspected Abuse or Neglectp. 781
Cultural Considerationsp. 781
Infants and Children with Special Needsp. 782
Tracheostomy Tubesp. 782
Home Artificial Ventilatorsp. 783
Central Intravenous Linesp. 783
Gastrostomy Tubes and Gastric Feedingp. 783
Shuntsp. 784
The EMT-B and Pediatric Emergenciesp. 784
Chapter Reviewp. 785
Street Scenesp. 786
Geriatric Patientsp. 788
The Geriatric Patientp. 789
Communicating with the Geriatric Patientp. 790
Assessing the Geriatric Patientp. 791
Cultural Considerationsp. 792
Reasons the Elderly Encounter EMSp. 795
Chapter Reviewp. 800
Street Scenesp. 800
Ambulance Operationsp. 804
Preparing for the Ambulance Callp. 806
Ambulance Supplies and Equipmentp. 807
Ensuring Ambulance Readiness for Servicep. 811
Receiving and Responding to a Callp. 814
Role of the Emergency Medical Dispatcherp. 814
Operating the Ambulancep. 816
Transferring the Patient to the Ambulancep. 822
Transporting the Patient to the Hospitalp. 823
Preparing the Patient for Transportp. 823
Caring for the Patient en Routep. 825
Transferring the Patient to the Emergency Department Staffp. 826
Terminating the Callp. 826
At the Hospitalp. 828
En Route to Quartersp. 830
In Quartersp. 831
Air Rescuep. 834
When to Call for Air Rescuep. 834
How to Call for Air Rescuep. 835
How to Set Up a Landing Zonep. 835
How to Approach a Helicopterp. 836
Chapter Reviewp. 837
Street Scenesp. 838
Gaining Access and Rescue Operationsp. 840
Vehicle Rescuep. 842
Preparing for the Rescuep. 842
Sizing Up the Situationp. 843
Recognizing and Managing Hazardsp. 844
Stabilizing a Vehiclep. 853
Gaining Accessp. 856
Chapter Reviewp. 861
Street Scenesp. 862
Special Operationsp. 864
Hazardous Materialsp. 866
Training Required by Lawp. 866
Responsibilities of the EMT-Bp. 868
Establish a Treatment Sectorp. 872
Multiple-Casualty Incidentsp. 877
Multiple-Casualty Incident Operationsp. 877
Incident Command Systemp. 878
Scene Managementp. 882
Transportation and Staging Logisticsp. 887
FYI: Psychological Aspects of MCIsp. 890
Chapter Reviewp. 891
Street Scenesp. 892
EMS Response to Terrorismp. 894
Defining Terrorismp. 895
Domestic Terrorismp. 895
International Terrorismp. 895
Types of Terrorism Incidentsp. 896
Terrorism and EMSp. 896
First Responders as Targetsp. 896
Identify the Threat Posed by the Eventp. 896
Cultural Considerationsp. 898
Recognize the Harms Posed by the Threatp. 899
Time/Distance/Shieldingp. 900
Responses to Terrorismp. 900
Responses to a Chemical Incidentp. 900
Responses to a Biological Incidentp. 901
Responses to a Radiological/Nuclear Incidentp. 903
Responses to an Explosive Incidentp. 904
Dissemination and Weaponizationp. 905
The Respiratory Routep. 905
Other Routesp. 905
Weaponizationp. 906
Characteristics of CBRNE Agentsp. 906
Chemical Agentsp. 906
Biological Agentsp. 907
Radioactive/Nuclear Devicesp. 916
Incendiary Devicesp. 917
Strategy and Tacticsp. 917
Isolationp. 918
Notificationp. 919
Identificationp. 919
Protectionp. 920
Chapter Reviewp. 921
Street Scenesp. 922
Study Guide: Self-Protection in a Terrorist Incidentp. 924
Advanced Airway Management
Advanced Airway Managementp. 928
Anatomy and Physiologyp. 930
Anatomyp. 930
Physiologyp. 931
Pediatric Airwayp. 932
Management of the Airwayp. 933
Oropharyngeal Suctioningp. 933
Orotracheal Intubationp. 933
Nasogastric Intubation of an Infant or Childp. 948
Orotracheal Suctioningp. 950
Multilumen Airwaysp. 950
Laryngeal Mask Airwayp. 954
Automatic Transport Ventilatorsp. 955
Chapter Reviewp. 956
Street Scenesp. 957
ALS-Assist Skillsp. A-1
Assisting with Endotracheal Intubationp. A-1
Preparing the Patient for Intubationp. A-1
Ventilating the Tubed Patientp. A-2
Assisting with a Trauma Intubationp. A-3
Applying ECG Electrodesp. A-4
Assisting in IV Therapyp. A-5
Setting Up an IV Fluid Administration Setp. A-5
Maintaining an IVp. A-7
Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP)p. A-7
Assisting with CPAP Devicesp. A-8
National Registry Skill Sheetsp. A-9
Basic Cardiac Life Support Reviewp. A-22
Before Beginning Resuscitationp. A-22
Assessing the Patientp. A-22
Activating EMSp. A-23
Positioning the Patientp. A-24
Opening the Airwayp. A-24
Initial Ventilations and Pulse Checkp. A-26
Rescue Breathingp. A-26
Mouth-to-Mask Ventilationp. A-28
Gastric Distentionp. A-28
Recovery Positionp. A-28
CPRp. A-28
Checking for Circulationp. A-28
How to Perform CPRp. A-29
One-Rescuer and Two-Rescuer CPRp. A-29
CPR Techniques for Children and Infantsp. A-32
Special Considerations in CPRp. A-32
When Not to Begin or to Terminate CPRp. A-34
Clearing Airway Obstructionsp. A-34
Partial Airway Obstructionp. A-35
Complete Airway Obstructionp. A-35
Reference Sectionp. R-1
Anatomy and Physiology Illustrationsp. R-2
Musculoskeletal Systemp. R-2
Nervous Systemp. R-4
Cardiovascular Systemp. R-6
Circulatory Systemp. R-7
Respiratory Systemp. R-8
Digestive Systemp. R-9
Urinary Systemp. R-10
Reproductive Systemp. R-11
Integumentary Systemp. R-12
Sensesp. R-13
Atlas of Injuriesp. R-14
Medical Terminologyp. R-18
Glossaryp. G-1
Indexp. I-1
Table of Contents provided by Ingram. All Rights Reserved.

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